Surgical devices with articulating end effectors and methods of using surgical devices with articulating end effectors

ABSTRACT

Methods and devices for using surgical devices with articulating end effectors are provided. Surgical devices with articulating end effectors can provide rotary driven pivoting of the end effector. In some embodiments, the device can include a handle, a first and a second tube extending from the handle, the second tube disposed within the first tube, and an end effector that includes a pair of distal jaws configured to move in response to rotation of the first tube about a longitudinal axis thereof and rotation of the second tube about a longitudinal axis thereof. The jaws can move in two different ways depending on whether the first and second tubes are rotating in a same direction as one another or in different ways than each other. The jaws can open/close and articulate using the same mechanical mechanism. The device can be powered, or the device can be non-powered.

CROSS-REFERENCE TO RELATED APPLICATIONS

This application is a continuation of U.S. patent application Ser. No.14/230,027 filed on Mar. 31, 2014, entitled “Surgical Devices withArticulating End Effectors and Methods of Using Surgical Devices withArticulating End Effectors, which is hereby incorporated by reference inits entirety.

FIELD

The present invention relates to surgical devices with articulating endeffectors and methods of using surgical devices with articulating endeffectors.

BACKGROUND

Minimally invasive surgical techniques such as endoscopies andlaparoscopies are often preferred over traditional surgeries because therecovery time, pain, and surgery-related complications are typicallyless with minimally invasive surgical techniques. Rather than cut openlarge portions of the body in order to access inner cavities, surgeonseither rely on natural orifices of the body or create one or more smallorifices in which surgical instruments can be inserted to allow surgeonsto visualize and operate at the surgical site.

Some minimally invasive procedures can require that a working end of adevice, which is inserted into the body, be articulated to angularlyreorient the working end relative to the tissue. During such aprocedure, for example, it is often necessary to reorient the workingend such that jaws at the working end are at an angle relative to ashaft of the device, while still allowing the jaws to open and close tograsp tissue. Such angulation is often achieved via one or more cablesattached to the jaws. However, with current cable driven jaw reorientingactuation systems, after articulation of the device, the cables aresubject to high tensions which makes opening and closing of the jawswith precision difficult.

Accordingly, there remains a need for improved surgical devices witharticulating end effectors and methods of using surgical devices witharticulating end effectors.

SUMMARY

A surgical device is provided that in one embodiment includes a proximalhandle portion, a first elongate shaft extending distally from theproximal handle portion, a second elongate shaft extending distally fromthe proximal handle portion and being disposed within a first passagewayof the first elongate shaft, a third elongate shaft extending distallyfrom the proximal handle portion and being disposed within a secondpassageway of the second elongate shaft, a first jaw having a proximalend operatively connected to a distal end of the first elongate shaft,and a second jaw having a proximal end operatively connected to a distalend of the second elongate shaft. The first and second elongate shaftscan be configured to simultaneously rotate about a longitudinal axis ofthe third elongate shaft with the third elongate shaft being stationaryrelative thereto. The rotation of the first and second elongate shaftscan angularly orient the first and second jaws relative to thelongitudinal axis of the third elongate shaft.

The device can have any number of additional features and/or variations.For example, the first and second jaws can be configured to angularlyorient in a same direction relative to the longitudinal axis of thethird elongate shaft in response to the first elongate shaft rotating ina first direction simultaneously with the second elongate shaft rotatingin a second direction that is opposite to the first direction. Foranother example, the first and second jaws can be configured to moveaway from one another in response to the first and second elongateshafts simultaneously rotating in a same direction. For yet anotherexample, the proximal end of the first jaw can be attached to the thirdelongate shaft at a pivot point, the proximal end of the second jaw canbe attached to the third elongate shaft at the pivot point, andangularly orienting the first and second jaws relative to thelongitudinal axis of the third elongate shaft can include pivoting thefirst and second jaws at the pivot point.

In another embodiment, a surgical device is provided that includes aproximal handle portion, an outer tube extending distally from thehandle portion, an inner tube extending distally from the proximalhandle portion and being disposed within a passageway of the outer tube,a first jaw having a proximal end operatively connected to a distal endof the outer tube, a second jaw having a proximal end operativelyconnected to a distal end of the inner tube, and an actuator coupled tothe handle portion and configured to be actuated so as to simultaneouslyrotate the inner and outer tubes, thereby articulating the first andsecond jaws relative to a common longitudinal axis of the inner andouter tubes.

The device can have any number of additional features and/or variations.For example, the actuation of the actuator can cause the inner tube torotate in a first direction and the outer tube to rotate in a seconddirection that is opposite to the first direction. For another example,the actuator can include a knob configured to be actuated by beingrotated in a first direction, thereby causing the outer tube to rotatein the first direction and causing the inner tube to rotate in a second,opposite direction, and configured to be actuated by being rotated inthe second direction, thereby causing the outer tube to rotate in thesecond direction and causing the inner tube to rotate in the firstdirection. For another example, the device can include a first helicalgear operatively connected to the outer tube, and a second helical gearoperatively connected to the inner tube. The actuation of the actuatorcan cause the first helical gear to rotate in a first direction so as tocause the outer tube to rotate in the first direction and can cause thesecond helical gear to rotate in a second direction that is opposite tothe first direction so as to cause the inner tube to rotate in thesecond direction. For another example, the device can include a movementassembly including a sleeve, a bushing disposed within the sleeve, afirst helical gear operatively connected to the outer tube andthreadably engaged with the bushing, and a second helical gearoperatively connected to the inner tube and threadably engaged with thebushing. The actuator can be operatively connected to the movementassembly such that the actuation of the actuator can cause the sleeveand the bushing to translate along the common longitudinal axis and cancause the first and second helical gears to rotate about the commonlongitudinal axis. For another example, the device can include a rodextending distally from the proximal handle portion and being disposedwithin a passageway of the inner tube. The inner and outer tubes cansimultaneously rotate relative to the rod in response to the actuationof the actuator. The first and second jaws can articulate relative tothe rod in response to the actuation of the actuator. For anotherexample, the device can include a motor, and the actuation of theactuator causing the motor to drive the rotation of the inner and outertube. The actuator can include a switch configured to electricallycommunicate with the motor.

For another example, the device can include a second actuator coupled tothe proximal handle portion and configured to be actuated so as tosimultaneously rotate the inner and outer tubes, thereby causing thefirst and second jaws to selectively open and close. The second actuatorcan include first and second handles configured to move toward and awayfrom one another, thereby causing the outer tube and the inner tube toboth rotate in a same direction. The device can include a first helicalgear operatively connected to the outer tube, and a second helical gearoperatively connected to the inner tube. The actuation of the secondactuator can cause the first and second helical gears to each rotate inone of a clockwise direction and a counterclockwise direction so as tocause the inner and outer tubes to each rotate in the one of theclockwise direction and the counterclockwise direction. The device caninclude a movement assembly including a sleeve, a bushing disposedwithin the sleeve, a first helical gear operatively connected to theouter tube and threadably engaged with the bushing, and a second helicalgear operatively connected to the inner tube and threadably engaged withthe bushing. The actuator can be operatively connected to the movementassembly such that the actuation of the actuator can cause the sleeveand the bushing to translate along the common longitudinal axis andcauses the first and second helical gears to rotate about the commonlongitudinal axis. The second actuator can be operatively connected tothe movement assembly such that the actuation of the second actuator cancause the bushing to rotate relative to the sleeve and causes the firstand second helical gears to rotate about the common longitudinal axis.

In another embodiment, a surgical device is provided that includes afirst jaw coupled to a first drive mechanism configured to rotate abouta first longitudinal axis of the first drive mechanism, and a second jawcoupled to a second drive mechanism configured to rotate about a secondlongitudinal axis of the second drive mechanism. The second drivemechanism can be independent of the first drive mechanism. The surgicaldevice can also include a motor operatively connected to the first andsecond drive mechanisms and configured to cause synchronous rotation ofthe first and second drive mechanisms so as to either drive the firstand second jaws to selectively open and close, or drive the first andsecond jaws to articulate in a same direction as one another.

The device can have any number of additional features and/or variations.For example, the first and second drive mechanisms can each include arigid tubular shaft. For another example, the surgical device caninclude a proximal handle portion. The first and second drive mechanismscan each extend distally from the proximal handle portion, and the firstand second jaws can be coupled to respective distal ends of the firstand second drive mechanisms. For yet another example, the first andsecond longitudinal axes can be coaxial. For another example, the firstand second longitudinal axes can be parallel to one another.

In another aspect, a surgical method is provided that in one embodimentincludes advancing jaws located at a distal end of a surgical instrumentinto a body. The surgical instrument can include a handle, an outer tubeextending distally from the handle, and an inner tube disposed withinthe outer tube and extending distally from the handle. The surgicalmethod can also include actuating a first actuator coupled to the handleso as to cause the inner and outer tubes to rotate in oppositedirections, thereby causing the jaws to articulate in a same directionas one another. The surgical method can also include actuating a secondactuator coupled to the handle so as to cause the inner and outer tubesto rotate in a same direction, thereby causing the jaws to selectivelyopen and close.

The method can have any number of additional features and/or variations.For example, actuating the first actuator can include rotating the firstactuator in a first direction or in a second direction that is oppositeto the first direction, the rotation of the first actuator in the firstdirection causing the outer tube to rotate in the first direction andcausing the inner tube to rotate in the second direction, and therotation of the first actuator in the second direction causing the outertube to rotate in the second direction and causing the inner tube torotate in the first direction. For another example, actuating the firstactuator can cause a motor to drive the rotation of the inner and outertube in the opposite directions. For a further example, the secondactuator can include first and second handles, and actuating the secondactuator can include moving the first and second handles toward and awayfrom one another.

BRIEF DESCRIPTION OF DRAWINGS

This invention will be more fully understood from the following detaileddescription taken in conjunction with the accompanying drawings, inwhich:

FIG. 1 is a perspective view of one embodiment of a surgical device;

FIG. 2 is a side, partial cross-sectional view of the surgical device ofFIG. 1;

FIG. 3 is a partial side, cross-sectional view of the surgical device ofFIG. 1;

FIG. 4 is an exploded view of components at least partially disposedwithin a housing of the surgical device of FIG. 1, and an end effectorof the surgical device of FIG. 1;

FIG. 5 is an exploded view of the surgical device of FIG. 1;

FIG. 6 is an exploded view of an end effector of the surgical device ofFIG. 1 and of a distal portion of an elongate shaft of the surgicaldevice of FIG. 1;

FIG. 7 is a cross-sectional view of the surgical device of FIG. 3;

FIG. 8 is another cross-sectional view of the surgical device of FIG. 3;

FIG. 9 is another cross-sectional view of the surgical device of FIG. 3;

FIG. 10 is a partially exploded view of a portion of the surgical deviceof FIG. 1 with the surgical device in a first orientation;

FIG. 11 is a partially exploded view of the surgical device of FIG. 10in a second orientation moved from the first orientation;

FIG. 12 is a partial cross-sectional view of the surgical device of FIG.10 in a third orientation moved from the first orientation;

FIG. 13 is an exploded view of the surgical device of FIG. 12;

FIG. 14 is a partial cross-sectional view of the surgical device of FIG.12 in a fourth orientation moved from the third orientation;

FIG. 15 is an exploded view of the surgical device of FIG. 14;

FIG. 16 is a partial cross-sectional view of the surgical device of FIG.10 in a fifth orientation moved from the first orientation;

FIG. 17 is an exploded view of the surgical device of FIG. 16;

FIG. 18 is a partial cross-sectional view of the surgical device of FIG.10 in a sixth orientation moved from the first orientation;

FIG. 19 is an exploded view of the surgical device of FIG. 18;

FIG. 20 is a perspective view of another embodiment of a surgicaldevice;

FIG. 21 is a side partial cross-sectional view of the surgical device ofFIG. 20;

FIG. 22 is a perspective cross-sectional view of the surgical device ofFIG. 20; and

FIG. 23 is an exploded view of the surgical device of FIG. 20.

DETAILED DESCRIPTION

Certain exemplary embodiments will now be described to provide anoverall understanding of the principles of the structure, function,manufacture, and use of the devices and methods disclosed herein. One ormore examples of these embodiments are illustrated in the accompanyingdrawings. Those skilled in the art will understand that the devices andmethods specifically described herein and illustrated in theaccompanying drawings are non-limiting exemplary embodiments and thatthe scope of the present invention is defined solely by the claims. Thefeatures illustrated or described in connection with one exemplaryembodiment may be combined with the features of other embodiments. Suchmodifications and variations are intended to be included within thescope of the present invention.

Further, in the present disclosure, like-named components of theembodiments generally have similar features, and thus within aparticular embodiment each feature of each like-named component is notnecessarily fully elaborated upon. Additionally, to the extent thatlinear or circular dimensions are used in the description of thedisclosed systems, devices, and methods, such dimensions are notintended to limit the types of shapes that can be used in conjunctionwith such systems, devices, and methods. A person skilled in the artwill recognize that an equivalent to such linear and circular dimensionscan easily be determined for any geometric shape. Sizes and shapes ofthe systems and devices, and the components thereof, can depend at leaston the anatomy of the subject in which the systems and devices will beused, the size and shape of components with which the systems anddevices will be used, and the methods and procedures in which thesystems and devices will be used.

Various exemplary surgical devices with articulating end effectors andmethods of using surgical devices with articulating end effectors areprovided. In general, the surgical devices with articulating endeffectors and methods of using surgical devices with articulating endeffectors can provide rotary driven pivoting of the end effector. Insome embodiments, the device can include a handle, a first tubeextending distally from the handle, a second tube extending distallyfrom the handle and being disposed within the first tube, and an endeffector that includes a pair of distal jaws configured to move inresponse to rotation of the first tube about a longitudinal axis thereofand rotation of the second tube about a longitudinal axis thereof. Thehandle can include at least one actuator configured to be actuated by auser so as to cause the rotation of the first and second tubes. The jawscan be configured to move in two different ways depending on whether thefirst and second tubes are rotating in a same direction as one anotheror in different ways than each other. In response to the first andsecond tubes rotating in a same direction as one another, e.g., bothclockwise or both counterclockwise, the jaws can be configured to moveby opening and closing, e.g., by moving toward and away from oneanother, which can facilitate clamping of tissue and/or other materialbetween the jaws. In response to the first and second tubes rotating indifferent directions from one another, e.g., one clockwise and the othercounterclockwise, the jaws can be configured to articulate togetherrelative to the longitudinal axes of the first and second tubes, whichcan facilitate angular positioning of the jaws relative to a tissueand/or other target to be clamped by the jaws. The jaws can thus beconfigured to be opened/closed and articulated using the same mechanicalmechanism, e.g., the first and second tubes, which can simplifymanufacturing and/or reduce monetary cost of the device by allowing fora fewer number of parts and less complex mechanical connections than ifseparate mechanisms were provided for articulating the jaws and foropening/closing the jaws. A proximal end of one of the jaws can beattached to a distal end of the outer tube, and a proximal end of theother of the jaws can be attached to a distal end of the inner tube,which can facilitate the movement of the jaws in response to therotation of the inner and outer tubes. The attachment of the proximalends of the jaws to respective ones of the inner and outer tubes canhelp provide high torque, speed, and strength for the movement of thejaws, e.g., because the inner and outer tubes are located proximal tothe jaws throughout movement of the jaws and do not extend across orbend at a pivot point about which the jaws rotate to open/close and toarticulate. The device can be powered, e.g., tube rotation driven usinga motor, or the device can be non-powered, e.g., mechanically driventube rotation.

In an exemplary embodiment, shown in FIGS. 1 and 2, a surgical device 2can include a proximal handle portion 4 having an elongate shaft 6extending distally therefrom. The shaft 6 can have a working element 8,also referred to herein as an “end effector,” at a distal end thereof.The end effector 8 can be coupled to the shaft 6 at a pivot joint 10. Aproximal end of the end effector 8 can be pivotally coupled to the joint10 at a distal end of the shaft 6. The end effector 8 in thisillustrated embodiment includes a tissue grasper having a pair ofopposed jaws 12 a, 12 b configured to move between open and closedpositions. The end effector 8 can have other configurations, e.g.,scissors, a babcock, etc. The jaws 12 a, 12 b can also be configured tomove between articulated positions where the jaws 12 a, 12 b are angledrelative to a longitudinal axis A of the shaft 6 so as to reorient thejaws 12 a, 12 b relative thereto. As discussed further below, the handleportion 4 can include a first actuator configured to effect the openingand closing of the opposed jaws 12 a, 12 b, e.g., movement of the jaws12 a, 12 b toward and away from one another. The handle portion 4 canalso include a second actuator 16 configured to effect the articulationof the opposed jaws 12 a, 12 b, e.g., movement of both jaws 12 a, 12 bin a same direction relative to the shaft's longitudinal axis A. Thearticulation can be independent of the opening and closing of the jaws12 a, 12 b.

The shaft 6 can have a variety of sizes, shapes, and configurations. Inan exemplary embodiment, the shaft 6 can be rigid, e.g., made from agenerally non-bendable material such as a metal (e.g., stainless steel,titanium, etc.) or a hard polymer. As shown in FIGS. 3 and 4, the shaft6 can include a central shaft 18, an inner tubular shaft 20, and anouter tubular shaft 22. The central shaft 18, the inner tubular shaft20, and the outer tubular shaft 22 can be coaxial with one another suchthat they all share the same longitudinal axis A, as in this illustratedembodiment, as shown in FIGS. 3, 7, and 8. Generally, the central shaft18 can be configured to remain stationary relative to the handle portion4, to the inner tubular shaft 20, and to the outer tubular shaft 22. Theinner tubular shaft 20 and the outer tubular shaft 22 can be configuredto move relative to the handle portion 4, to the central shaft 18, andto each other, as discussed further below.

The shaft 6 can have any longitudinal length, although in an exemplaryembodiment it can be long enough to allow the handle portion 4 to bemanipulated outside a patient's body while the shaft 6 extends throughan opening in the body with the end effector 8 disposed within a bodycavity, e.g., have a longitudinal length of about 33 cm. In this way,the end effector 8 can be easily manipulated when the device 2 is in useduring a surgical procedure. The shaft 6 can have any diameter. Forexample, the shaft's diameter can be less than or equal to about 10 mm,e.g., less than or equal to about 7 mm, less than or equal to about 5mm, etc., which can allow for insertion of the shaft 6 through anminimally invasive access device, such as during a laparoscopic surgicalprocedure. The end effector 8 mated to the shaft's distal end can have adiameter equal to or less than the shaft's diameter, at least when thejaws 12 a, 12 b are in the closed position, which can facilitateinsertion of the device's distal portion into a patient's body.

The central shaft 18 can have a variety of sizes, shapes, andconfigurations. In an exemplary embodiment, the central shaft 18 can berigid. The central shaft 18 can be fixedly attached to the handleportion 4, e.g., at a proximal end of the central shaft 18, so as to bein a fixed position relative to the handle portion 4. The central shaft18 can extend from the handle portion 4 through a distal opening 24defined by a main housing 38 of the handle portion 4, as shown in FIGS.2, 3, and 5. A distal end of the central shaft 18 can define the pivotjoint 10 at which the jaws 12 a, 12 b can be pivotally attached to theshaft 6. The jaws 12 a, 12 b can be attached to the central shaft 18 viaa pin 11 (the pin 11 is not shown in FIG. 4). The end effector 8 can bemechanically attached to the inner and outer tubular shafts 20, 22 atlocations proximal to the joint 10, as discussed further below.

The inner tubular shaft 20, also referred to herein as an “inner tube,”can have a variety of sizes, shapes, and configurations. In an exemplaryembodiment, the inner tube 20 can be rigid. The inner tube 20 can haveits distal end located proximal to the joint 10, e.g., proximal to thedistal end of the central shaft 18, as shown in FIGS. 3 and 6, which canfacilitate pivoting of a first, top one of the jaws 12 a about the joint10. The inner tube 20 can be freely rotatable relative to the outertubular shaft 22 and the central shaft 18 about the longitudinal axis A.A proximal portion of the inner tube 20 can extend into the handleportion 4 with a proximal end thereof position within the handle portion4, as shown in FIG. 3. The inner tube 20 can extend distally from thehousing 38 through the distal opening 24 of the handle portion 4. Asshown in FIGS. 4 and 6, the inner tube 20 can have teeth 26 extendingpartially around a circumference of the distal end thereof. The teeth 26can be operatively engaged with the first jaw 12 a, as discussed furtherbelow. A number of the teeth 26 can vary based on factor(s) such as asize of the teeth, a size of the inner tube 20, a shape of the teeth 26,etc.

The outer tubular shaft 22, also referred to herein as an “outer tube,”can have a variety of sizes, shapes, and configurations. In an exemplaryembodiment, the outer tube 22 can be rigid. The outer tube 22 can befreely rotatable relative to the inner tube 20 and the central shaft 18about the longitudinal axis A. A proximal portion of the outer tube 22can extend into the handle portion 4 with a proximal end thereofpositioned within the handle portion 4, as shown in FIG. 3. The outertube 22 can extend distally from the housing 38 through the distalopening 24 of the handle portion 4. As shown in FIGS. 4 and 6, the outertube 22 can have teeth 28 extending partially around a circumference ofa distal end thereof. A number of the teeth 28 can vary based onfactor(s) such as a size of the teeth, a size of the outer tube 22, ashape of the teeth 28, etc. The outer tube's teeth 28 can be operativelyengaged with a second, bottom one of the jaws 12 b. The teeth 28 formedon the outer tube 22 can be on an opposite side of the shaft 6 than theteeth 26 formed on the inner tube 20. For example, as shown in FIG. 6,the outer tube's teeth 28 can be formed on a left side of the shaft 6,and the inner tube's teeth 26 can be formed on a right side of the shaft6. In another embodiment, the outer tube's teeth 28 can be formed on aright side of the shaft 6, and the inner tube's 26 teeth can be formedon a left side of the shaft 6.

In some embodiments, only one of the inner and outer tubes can haveteeth formed thereon, and only one of the jaws can have correspondingteeth operatively engaged therewith. In this way, instead of both thefirst and second jaws 12 a, 12 b being moveable in response to movementof the inner and outer tubes 20, 22 as in the illustrated embodiment ofFIG. 1, only one of the jaws can be moveable (the jaw with teeth)relative to the central shaft 18 while the other jaw is configured toremain stationary relative to the central shaft 18.

The end effector 8 can have a variety of sizes, shapes, andconfigurations. In an exemplary embodiment, the end effector 8 can berigid. As shown in FIG. 1, the end effector 8, including the first andsecond jaws 12 a, 12 b, can be disposed at a distal end of the surgicaldevice 2. The end effector 8 can include the first jaw 12 a and thesecond jaw 12 b pivotally connected to the central shaft 18 at the joint10. As shown in FIG. 6, each of the first jaw 12 a and the second jaw 12b can include a gripping feature 32 a, 32 b, respectively, on tissueengaging surfaces of the jaws 12 a, 12 b. The gripping features 32 a, 32b can contact one another when the end effector 8 is in a closedposition and the end effector 8 is not holding tissue and/or othermatter therebetween, as shown in FIGS. 1, 3, and 5. In otherembodiments, the gripping features 32 a, 32 b may not contact oneanother when the end effector 8 is closed, e.g., the tissue engagingsurfaces of the jaws 12 a, 12 b have a space therebetween when the jaws12 a, 12 b are fully closed. The gripping feature 32 a, 32 b can beconfigured to provide the end effector 8 with a greater ability to griptissue and/or other matter between the jaws 12 a, 12 b. This enhancedgripping ability can be accomplished via an increased coefficient offriction of the gripping features 32 a, 32 b. The gripping features 32a, 32 b can include a plurality of ridges, as in this illustratedembodiment. The gripping features 32 a, 32 b can have otherconfigurations, such as a plurality of bumps, a textured surface, aroughened surface, and/or other enhanced coefficient of frictionenhancing surfaces. The first jaw 12 a and the second jaw 12 b can eachhave a pivot hole 30 a, 30 b, respectively, at proximal ends thereofthat facilitate securing of the jaws 12 a, 12 b to the pivot joint 10via the pin 11 that can be positioned within the pivot holes 30 a, 30 b(the pin 11 is not shown in FIG. 6).

The first jaw 12 a at the proximal end thereof can have a roundedprofile about the pivot hole 30 a. The first jaw 12 a can have teeth 34which are defined in the rounded profile. The first jaw's teeth 34 canbe configured to operatively mate with the teeth 26 of the inner tube20. Upon rotation of the inner tube 20, the teeth 26 of the inner tube20 can moveably engage the teeth 34 of the first jaw 12 a so as torotate the first jaw 12 a about the joint 10 so as to angularly adjustthe first jaw 12 a relative to the shaft's longitudinal axis A. Therotation of the first jaw 12 a can be independent of the rotation of thesecond jaw 12 b, as discussed further below.

The second jaw 12 b can generally be configured similar to the first jaw12 a, except the second jaw 12 b can be operatively mated to the outertube 22 instead of the inner tube 20. The second jaw 12 b at theproximal end thereof can have a rounded profile about the pivot hole 30b. The second jaw 12 b can have teeth 36 which are defined in therounded profile. The second jaw's teeth 36 can be configured tooperatively mate with the teeth 28 of the outer tube 22. Upon rotationof the outer tube 22, the teeth 28 of the outer tube 22 can moveablyengage the teeth 36 of the second jaw 12 b so as to rotate the secondjaw 12 b about the joint 10 so as to angularly adjust the second jaw 12b relative to the shaft's longitudinal axis A. The rotation of thesecond jaw 12 b can be independent of the rotation of first jaw 12 asince the second jaw's movement can be controlled by movement of theouter tube 22 while movement of the first jaw 12 a can be controlled bymovement of inner tube 20. In this way, the first jaw 12 a can beconfigured to move in response to movement of the inner tube 20, and thesecond jaw 12 b can be configured to move in response to movement of theouter tube 22.

The handle portion 4 can have a variety of sizes, shapes, andconfigurations. The handle portion 4 can include the main housing 38,which can house a variety of elements therein and can have some elementsaccessible outside thereof, such as the first actuator and the secondactuator. The main housing 38 can include first and second halves 38 a,38 b, as shown in FIG. 5. The halves 38 a, 38 b can be fixedly attachedtogether, e.g., fixed together during manufacturing of the device 2,which can help protect the elements disposed therein.

In an exemplary embodiment, the first actuator can include first andsecond gripper arms 14 a, 14 b, also referred to herein as “handles.” Asshown in FIGS. 1-3, each of the gripper arms 14 a, 14 b can be pivotallyattached to the main housing 38 at a handle pivot point 40 a, 40 b,respectively. Each of the arms 14 a, 14 b can include an elongate member15 a, 15 b, respectively, each having a finger loop 17 a, 17 b and athumb rest 19 a, 19 b, similar to scissors. The arms 14 a, 14 b can, inother embodiments, have different sizes, shapes, and configurations,e.g., no thumb rests, multiple finger loops, different arcuate shape,etc. The arms 14 a, 14 b can be configured to move toward and away fromthe main housing 38, thereby actuating the inner and outer tubes 20, 22and hence the end effector 8. The arms 14 a, 14 b can be operativelyconnected to the inner and outer tubes 20, 22 such that actuation of thearms 14 a, 14 b, e.g., manual movement thereof by a user, can causemovement of the inner and outer tubes 20, 22. As discussed furtherbelow, actuation of the first actuator 14 a, 14 b can cause the innerand outer tubes 20, 22 to each rotate in a same direction about theshaft's longitudinal axis A.

In an exemplary embodiment, the second actuator can include anarticulation knob 16. The articulation knob 16 can have a variety ofsizes, shapes, and configurations. The articulation knob 16 can berigid. The articulation knob 16 can include a moveable ring. Thearticulation knob 16 can be proximal to the pivot points 40 a, 40 b ofthe handles 14 a, 14 b, as in this illustrated embodiment. Thearticulation knob 16 can be two separate semi-circular parts 16 a, 16 bthat can be fixedly assembled together, e.g., during manufacturing, orthe knob 16 can be a singular piece as in this illustrated embodiment.The articulation knob 16 can be rotatably coupled to the main housing38. The articulation knob 16 can sit in a recess 68 formed in thehousing 38, as shown in FIG. 5. The articulation knob 16 can include atleast one pin 74 extending radially inward therefrom, e.g., extendingradially inward from an interior surface thereof. The articulation knob16 includes a single pin 74 in this illustrated embodiment, as shown inFIG. 5, but the knob 16 can include multiple pins. The housing 38 canhave at least one slot 72 formed therein, e.g., in the recess 68, thatcan be configured to have the at least one pin 74 extendingtherethrough. The at least one pin 74 can be configured to slide withinthe at least one slot 72 when the knob 16 is actuated, e.g., rotated.

The articulation knob 16 can include one or more finger depressions onan exterior surface thereof, as in this illustrated embodiment. Thefinger depressions can facilitate manual movement of the knob 16 usingone or more fingers seated in the finger depressions. The fingerdepressions in this illustrated embodiment extend around an entirecircumference of the knob's exterior surface.

The articulation knob 16 can include at least one detent ball 76 a, 76b. The knob 16 includes two detent balls 76 a, 76 b in this illustratedembodiment, as shown in FIGS. 5 and 7. Each of the detent balls 76 a, 76b can each be sized to fit within a bore formed within the articulationknob 16. The at least one detent ball 76 a, 76 b can be biased radiallyinward by at least one spring 78 a, 78 b. The articulation knob 16includes two springs 78 a, 78 b in this illustrated embodiment, one foreach of the detent balls 76 a, 76 b. Each of the detent balls 76 a, 76 bcan be configured to be seated in one of a plurality of correspondingdetent depressions 70 formed in the housing 38 in the recess 68 in whichthe knob 16 can be seated. The detent depressions 70 can extend aroundat least a partial circumference of the recess 68, as shown in FIGS. 5and 7. The detent balls 76 a, 76 b and the detent depressions 70 cancooperate to help hold the articulation knob 16 in a selected rotationalposition relative to the housing 38, and hence help hold the jaws 12 a,12 b in a selected articulated position relative to the shaft 6. As theknob 16 is rotated about the longitudinal axis A, the detent ball 76 a,76 b can move between being seated in adjacent ones of the detentdepressions 70, which can hold the detent balls 76 a, 76 b therein so asto restrain the knob 16 from freely rotating, without actuation thereofby a user. The movement of the detent balls 76 a, 76 b between adjacentdepressions 70 can be palpably felt by a user manually moving the knob16, which can help the user controllably and predictably move the knob16 and hence controllably and predictably articulate the end effector 8.Each of the depressions 70 can correspond to one articulated position ofthe end effector 8.

The articulation knob 16 can be operatively connected to the inner andouter tubes 20, 22 such that actuation of the articulation knob 16,e.g., manual movement thereof by a user, can cause movement of the innerand outer tubes 20, 22. The movement of the inner and outer tubes 20, 22in response to the knob's 16 movement can be in a different manner thanthe movement of the inner and outer tubes 20, 22 caused by the firstactuator 14 a, 14 b. As discussed further below, activation of thesecond actuator 16 can cause the inner and outer tubes 20, 22 to rotatein an opposite directions from one another, e.g., one clockwise and theother counterclockwise, about the shaft's longitudinal axis A.

In an exemplary embodiment, the articulation knob 16 can be configuredto be actuated so as to cause the jaws 12 a, 12 b to articulate about±60°. In other words, the articulation knob 16 can be configured toarticulate the end effector 8 upward 60° relative to the longitudinalaxis A and downward 60° relative to the longitudinal axis A.

As mentioned above, a proximal portion of the central shaft 18 can bedisposed within the housing 38. As shown in FIGS. 3 and 4, the centralshaft 18 can be attached to an anchor member 42 disposed within thehousing 38. The anchor member 42 can be configured to prevent thecentral shaft 18 from rotating or otherwise moving relative to thehousing 38. The anchor member 42 can be attached to interior surfaces ofthe housing halves 38 a, 38 b, as shown in FIG. 5, so as to secure thecentral shaft 18 in a fixed position relative to the housing 38. Theanchor member 42 can be attached to the central shaft 18 via one or moreanchor pins 42 a, 42 b. The central shaft 18 can, at the proximal endthereof, have one or more through holes 18 a, 18 b formed therein intowhich the one or more anchor pins 42 a, 42 b can be disposed to securethe central shaft 18 to the anchor member 42. The central shaft 18 canadditionally or alternatively be attached to the housing 38 in otherways, such as by being welded thereto, adhered thereto using adhesive,molded therewith, etc.

The central shaft 18 can have an inner tube bias member 48 and an outertube bias member 50 disposed therearound. The bias members 48, 50 can belocated distal to the anchor member 42, as in this illustratedembodiment. The bias members 48, 50 can be coaxial, and the inner tubebias member 48 can be disposed within the outer tube bias member 50, asshown in FIG. 3. The bias members 48, 50 are each coil springs in theillustrated embodiment, but the bias members 48, 50 can have otherconfigurations, e.g., a volute spring, a flat spring, a rubber band,etc. A proximal end of the inner tube bias member 48 can abut the anchormember 42, and a distal end of the inner tube bias member 48 can abutthe proximal end of the inner tube 20. The inner tube bias member 48 canbe configured to bias the inner tube 20 in a distal direction along thelongitudinal axis A so as to help maintain the inner tube's teeth 26 inoperative engagement with the first jaw's teeth 34. A proximal end ofthe outer tube bias member 50 can abut the anchor member 42, and theouter tube bias member 50 can be configured to bias the outer tubemember 22 in a distal direction along the longitudinal axis A so as tohelp maintain the outer tube's teeth 28 in operative engagement with thesecond jaw's teeth 36.

The surgical device 2 can include a movement assembly configured tofacilitate rotation of the inner and outer tubes 20, 22 in response toselective actuation of the first actuator 14 a, 14 b and the secondactuator 16. The movement assembly can be operatively connected to boththe first actuator 14 a, 14 b and the second actuator 16 to provide forthe selected actuation, e.g., the jaw opening/closing via the firstactuator 14 a, 14 b or the jaw articulation via the second actuator 16.As shown in FIGS. 3-5, 8, and 9, the movement assembly can include afirst helical gear 44, a second helical gear 46, a drive bushing 52, andan articulation sleeve 60. The first helical gear 44 and the secondhelical gear 46 can be axially aligned with the shaft's longitudinalaxis A. The first and second helical gears 44, 46 can be disposed withinthe drive bushing 52. The drive bushing 52 can be disposed at leastpartially within the articulation sleeve 60. The first helical gear 44,the second helical gear 46, the drive bushing 52, and the articulationsleeve 60 can all be coaxially aligned, as in this illustratedembodiment.

The first helical gear 44, also referred to herein as a first “drum,”can have a variety of sizes, shapes, and configurations. In an exemplaryembodiment, the first helical gear 44 can be rigid and can becannulated. The first helical gear 44 can be fixedly attached to theinner tube 20, such as by a proximal end of the inner tube 20 beingfixedly attached to the first helical gear 44, e.g., via welding,adhesive, etc. In this way, rotation of the first helical gear 44 cancause the inner tube 20 to rotate in the same direction as the firsthelical gear 44. The first helical gear 44 can be longitudinally fixedrelative to the inner tube 20 and to the housing 38. The first helicalgear 44 can have a first thread 45 formed in an exterior surfacethereof. The first thread 45 can, as in this illustrated embodiment,include a plurality of discrete threads. The first thread 45 can beconfigured as a groove formed in the first drum's exterior surface. Thefirst thread 45 is right-handed in this illustrated embodiment, but inanother embodiment, the first thread 45 can be left-handed.

The second helical gear 46, also referred to herein as a second “drum,”can have a variety of sizes, shapes, and configurations. The secondhelical gear 46 can generally be configured similar to the first helicalgear 44. In an exemplary embodiment, the second helical gear 46 can berigid and can be cannulated. The second helical gear 46 can be fixedlyattached to the outer tube 22, such as by a proximal end of the outertube 22 being fixedly attached to the second helical gear 46, e.g., viawelding, adhesive, etc. In this way, rotation of the second helical gear46 can cause the outer tube 22 to rotate in the same direction as thesecond helical gear 46. The second helical gear 46 can be longitudinallyfixed relative to the outer tube 22 and to the housing 38. The secondhelical gear 46 can be located distal to the first helical gear 44 alongthe shaft's longitudinal axis A. In another embodiment, the firsthelical gear 44 can be located distal to the second helical gear 46. Aproximal face of the second helical gear 46 can abut a distal face ofthe first helical gear 44, as in this illustrated embodiment, as shownin FIG. 3. The second helical gear 46 can have a second thread 47 formedin an exterior surface thereof. The second thread 47 can, as in thisillustrated embodiment, include a plurality of discrete threads. Thesecond thread 47 can be configured as a groove formed in the seconddrum's exterior surface. The first and second threads 45, 47 can spiralin opposite direction from one another, e.g., the first thread 45 beingright-handed and the second thread 47 being left-handed. The oppositespiraling of the first and second threads 45, 47 can facilitateindependent rotation of the inner and outer tubes 20, 22 as discussedfurther below.

The drive bushing 52 can have a variety of sizes, shapes, andconfigurations. In an exemplary embodiment, the drive bushing 52 can berigid. As shown in FIGS. 3-5, 8, and 9, the drive bushing 52 can be havethe first and second helical gears 44, 46 disposed within an inner lumenthereof. The drive bushing 52 can be coaxial with the first and secondhelical gears 44, 46, as in this illustrated embodiment. The drivebushing 52 is shown in FIG. 4 in an exploded view as two halves similarto the housing halves 38 a, 38 b, however the drive bushing 52 can be asingle piece or can be more than two pieces attached together. The drivebushing 52 can include at least two pins that each extend radiallyinward, e.g., extend radially inward from an interior surface of thedrive bushing 52. At least one of the pins can be seated in the thread45 of the first helical gear 44, and at least one other of the pins canbe seated in the thread 47 of the second helical gear 46. In thisillustrated embodiment, the bushing 52 includes four pins, two engagedwith the first thread 45 and two engaged with the second thread 47. Onlyfirst and second ones of the pins 52 a, 52 b are visible in FIG. 4, anda fourth pin 52 c is visible in FIG. 8. A third one of the pins isobscured but is similar to the illustrated first, second, and third pins52 a, 52 b, 52 c. The first pin 52 a and the third pin can be engagedwith the first thread 45. The second pin 52 b and the fourth pin 52 ccan be engaged with the second thread 47.

The first actuator 14 a, 14 b can be operatively connected to the drivebushing 52. The drive bushing 52 can have pivot connections 51 a, 51 bon opposite sides thereof. The pivot connections 51 a, 51 b can allowfor the arms 14 a, 14 b to be pivotally connected to the drive bushing52. As the arms 14 a, 14 b are moved toward and away from the mainhousing 38, the pivot connections 51 a, 51 b can facilitate rotation ofthe drive bushing 52 about the longitudinal axis A, as discussed furtherbelow.

The arms 14 a, 14 b can be pivoted by a user, e.g., moved toward andaway from the housing 38, so as to open and close the jaws 12 a, 12 b ofthe end effector 8. As shown in FIGS. 2, 5, and 9, the arms 14 a, 14 beach can have a drive link 54 a, 54 b pivotally attached thereto at anintermediate location of the arms 14 a, 14 b between proximal and distalends thereof. Each of the drive links 54 a, 54 b can include a holeconfigured to movably attach to a ball joint 56 a, 56 b, respectfully,of each handle 14 a, 14 b, as shown in FIGS. 5 and 9. At an opposite endof the drive link 54 a, 54 b from the holes attached to the ball joints56 a, 56 b, the drive links 54 a, 54 b can be pivotally attached to thedrive bushing 52 at the first and second pivot connections 51 a, 51 b,respectively. The first and second drive links 54 a, 54 b can bepivotally attached to the pivot connections 51 a, 51 b via first andsecond pins 58 a, 58 b, respectively. This coupling of the arms 14 a, 14b to the drive bushing 52 via the drive links 54 a, 54 b, can allow forthe drive bushing 52 to rotate about the longitudinal axis A in responseto the drive arms 14 a, 14 b being actuated, e.g., moved toward or awayfrom the main housing 38, as discussed further below.

The articulation sleeve 60 can have a variety of sizes, shapes, andconfigurations. The articulation sleeve 60 can be rigid. Thearticulation sleeve 60 can have an interior cavity in which firsthelical gear 44, the second helical gear 46, and the drive bushing 52can be disposed, as shown in FIG. 4. The bushing 52 can be disposedwithin the sleeve 60 at a fixed longitudinal position relative thereto,as shown in FIG. 3 in which a proximal face of the bushing 52 abuts adistal face of the sleeve 60 and a distal face of the bushing 52 abuts aproximal face of the sleeve 60. The articulation sleeve 60 can becoaxially aligned with the outer tube spring 50, the drive bushing 52,and the shaft 6. The articulation sleeve 60 can include multiple pieces,e.g., two halves, or the articulation sleeve 60 can be a single piece,similar to the housing 38 that can be one or more pieces. In thisillustrated embodiment, the articulation sleeve 60 is a single piece.

The articulation sleeve 60 can include at least one opening 61 a, 61 btherein that extends through a sidewall thereof. The at least oneopening 61 a, 61 b can be configured to have the pivot connections 51 a,51 b of the drive bushing 52 exposed and/or extending therethrough,which can allow the drive links 54 a, 54 b to be attached to the drivebushing 52 with the drive bushing 52 seated within the sleeve 60. Upperand lower edges of the at least one opening 61 a, 61 b can be configuredto limit the rotation of the drive bushing 52 relative to thearticulation sleeve 60, as the pivot connections 51 a, 51 b can abut theupper and lower edges, depending on a direction of the bushing'srotation, so as to stop the bushing's rotation. The opening's upper andlower edges can thus be configured to limit the bushing's rotation pastupper and lower vertical limits of the at least one opening 61 a, 61 b.The at least one opening 61 a, 61 b can be located in a proximal portionof the sleeve 60.

The proximal portion of the articulation sleeve 60 can include at leastone guide rail 66 a, 66 b configured to facilitate longitudinal movementof the sleeve 60 relative to the housing 38. In this illustratedembodiment, the sleeve 60 includes two guide rails 66 a, 66 b, one on atop surface thereof and the other on a bottom surface thereof, but thesleeve 60 can include any number of guide rails in these and/or otherlocations. The guide rails 66 a, 66 b can be configured to slide withincorresponding guide tracks 67 a, 67 b formed in in the main housing 38.The tracks 67 a, 67 b and the rails 66 a, 66 b can cooperate to limitlongitudinal movement of the sleeve 60 proximally and distally, e.g., toconstrain movement of the articulation sleeve 60 along the longitudinalaxis A. The tracks 67 a, 67 b and the rails 66 a, 66 b can alsocooperate to help smoothly longitudinally move the sleeve 60 proximallyand distally. The first and second guides 66 a, 66 b can be locatedalong at least a length of the at least one opening 61 a, 61 b, as inthis illustrated embodiment. In another embodiment, the housing 38 caninclude one or more guide rails, and the sleeve 60 can include one ormore corresponding guide tracks.

A distal portion of the articulation sleeve 60 can include at least onethread 68 formed in an outer surface thereof. The at least one thread 68of the sleeve 60 can include a groove formed in the sleeve's exteriorsurface. The sleeve thread 68 is left-handed in this illustratedembodiment, but in another embodiment, the sleeve thread 68 can beright-handed. A direction of the sleeve thread 68 can dictate whetherthe end effector 8 articulates up or down relative to the longitudinalaxis A in response to actuation of the second actuator 16, as discussedfurther below.

The drive bushing 52 can be configured to rotate about the longitudinalaxis A, relative to the actuation sleeve 60, in response to actuation ofthe first actuator 14 a, 14 b. The first pin 52 a and the third pin canbe engaged with the first thread 45 of the first helical gear 44, e.g.,the first pin 52 a and the third pin can be seated within the grooveformed in the first drum's exterior surface, and the second pin 52 b andfourth pin 52 c can be engaged with the second thread 47 of the secondhelical gear 46, e.g., the second pin 52 b and the fourth pin 52 c canbe seated within the groove formed in the second drum's exteriorsurface. As the bushing 52 rotates, the pins can push their respectivehelical gears 44, 46, e.g., by the pins pushing against sidewalls of thethread 45, 47 in which they are seated. The rotation of the bushing 52can thus cause the helical gears 44, 46 to be rotated in a samedirection as the drive bushing 52, e.g., both clockwise or bothcounterclockwise. The helical gears 44, 46 can remain in alongitudinally fixed position during this rotation. The sleeve 60 canremain fixed longitudinally and rotationally when the bushing 52 and thegears 44, 46 rotate. As mentioned above, the first and second helicalgears 44, 46 can be operatively connected to the inner and outer tubes20, 22 such that the rotation of the helical gears 44, 46 can causetheir connected one of the tubes 20, 22 to also rotate. In other words,as the first and second helical gears 44, 46 rotate in the samedirection, they can drive the inner and outer tubes 20, 22,respectively, in the same direction. The rotation of the inner tube 20can cause the first jaw 12 a to pivot at the joint 10 in a firstdirection, and the rotation of the outer tube 22 in the same directionas the inner tube 20 can cause the second jaw 12 b to pivot in a seconddirection that is opposite to the first direction. Thus, when the innerand outer tubes 20, 22 rotate in a same direction as one another, thejaws 12 a, 12 b can pivot in opposite directions from one another. Whenthe jaws 12 a, 12 b pivot in opposite directions, the movement eitheropens or closes the jaws 12 a, 12 b depending on whether the jaws 12 a,12 b are moving toward one another (jaws closing) or away from oneanother (jaws opening). Whether the jaws 12 a, 12 b open or close candepend on whether the handles 14 a, 14 b are being moved toward thehousing 38 (jaws closing) or away from the housing 38 (jaws opening).

The articulation sleeve 60 can be configured to move in response toactuation of the second actuator 16. The at least one pin 74 of the knob16 can be seated within the groove formed in the sleeve's outer surface.When the second actuator 16 is actuated, e.g., when the articulationknob 16 is rotated, the at least one pin 74 of the knob 16 can slidewithin the at least one slot 72. Because the knob 16 can be in a fixedlongitudinal position by being seated within the recess 68, the movementof the at least one pin 74 seated within the sleeve thread 68 can causethe sleeve 60 to move longitudinally in response to rotation of the knob16.

The longitudinal movement of the sleeve 60 can cause the drive bushing52 seated therein to also move longitudinally. The bushing 52 being at afixed longitudinal position relative to the sleeve 60, as mentionedabove, can allow for the sleeve's longitudinal movement to causelongitudinal movement of the bushing 52. As the drive bushing 52 moveslongitudinally, the second pin 52 b and the fourth pin 52 c engaged withthe second thread 47 of the second helical gear 46 can slide within thesecond thread 47 so as to rotate the second helical gear 46 in a firstdirection. Similarly, as the drive bushing 52 moves longitudinally, thefirst pin 52 a and the third pin engaged with the first thread 45 of thefirst helical gear 44 can slide within the first thread 45 so as torotate the first helical gear 44 in a second direction that is oppositeto the first direction. The first and second helical gears 44, 46 canrotate in the opposing first and second directions due to the first andsecond threads 45, 47 of the first and second helical gears 44, 46having opposite helical directions. The first and second directions candepend on whether the knob 16 is turned clockwise or counterclockwise.In this illustrated embodiment, the knob 16 rotating clockwise can causethe sleeve 60 to move in a distal direction, which can cause the outertube 22 to rotate clockwise and the inner tube 20 to rotatecounterclockwise, and the knob 16 rotating counterclockwise can causethe sleeve 60 to move in a proximal direction, which can cause the outertube 22 to rotate counterclockwise and the inner tube 20 to rotateclockwise.

As the first helical gear 44 is rotated in the first direction, thefirst helical gear 44 can drive the inner tube 20 to rotate in the firstdirection. As the inner tube 20 is driven in the first direction, theinner tube 20 can cause the first jaw 12 a to pivot at the joint 10. Asthe second helical gear 46 is rotated in the second direction, thesecond helical gear 46 can drive the outer tube 22 in the seconddirection. As the outer tube 22 is driven in the second direction, theouter tube 22 can drive the second jaw 12 b to pivot at the joint 10 ina same direction as the first jaw 12 a. The jaws 12 a, 12 b can thusarticulate in response to actuation of the second actuator 16.

The surgical device 2 can be manipulated into various configurations asshown in embodiments illustrated in FIGS. 10-19. These differentconfigurations can be achieved by manipulating the first actuator 14 a,14 b and the second actuator 16 in a variety of different ways, asdiscussed further below. Although certain configurations are discussedwith respect to FIGS. 10-19 as being “first,” “second,” etc., theconfigurations can be achieved in a different order depending on anorder of a user's selected actuation of the first actuator 14 a, 14 band second actuator 16. In some uses of the device 2, not allconfigurations will be achieved, such as if a user never needs toarticulate the end effector 8 downward during use of the device 2 in asurgical procedure. For clarity of illustration, the drive bushing 52 isnot shown in FIGS. 12, 14, 16, and 18.

FIG. 10, as well as FIGS. 1-3, show the device 2 in a first, defaultconfiguration in which the jaws 12 a, 12 b are closed and are notpivoted relative to the longitudinal axis A of the shaft 6, e.g., arenon-articulated. As discussed above, the handles 14 a, 14 b can bepivoted toward the main housing 38, similar to movement of scissorhandless. FIG. 11 shows movement of the device 2 from the firstconfiguration to a second configuration in which the jaws 12 a, 12 bhave moved from being closed to being open. As the arms 14 a, 14 b arepivoted at the handle pivot points 40 a, 40 b relative to the mainhousing 38, the drive links 54 a, 54 b transfer the movement of the arms14 a, 14 b to rotation of the drive bushing 52. The drive links 54 a, 54b can cause the drive bushing 52 to rotate about the shaft'slongitudinal axis A. As the arms 14 a, 14 b are pivoted toward oneanother and toward the housing 18, the first drive link 54 a moves upand the second drive link 54 b moves down so as to cause the drivebushing 52 to rotate in a first direction R1, e.g., clockwise, whichcauses the first pin 52 a and the third pin engaged in the first thread45 of the first helical gear 44 to drive the first helical gear 44 torotate in the first direction R1. As the first helical gear 44 rotatesin the first direction R1, the inner tube 20 rotates in the firstdirection R1. Similarly, the drive bushing 52 rotating in the firstdirection R1 causes the second pin 52 b and the fourth pin 52 c engagedin the second thread 47 of the second helical gear 46, thereby drivingthe second helical gear 46 to rotate in the first direction R1, andhence the outer tube 22 to rotate in the first direction R1. Therotation of inner and outer tube 20, 22 in the same first direction R1can drive teeth 34, 36 of the jaws 12 a, 12 b, respectfully, to rotatethe jaws 12 a, 12 b away from one other so as to open the end effector8, as shown in FIG. 11. The end effector 8 can be closed similar to thatdiscussed above regarding the end effector 8 being opened. In general,the handles 14 a, 14 b can moved toward one another and toward thehousing 38 so as to rotate the bushing 52 about the longitudinal axis Ain a second direction R2, e.g., counterclockwise, thereby causing thefirst and second helical gears 44, 46, the inner tube 20, and the outertube 22 to also rotate in the second direction R2 so as to cause thejaws 12 a, 12 b to move toward one another toward the closed position.

FIGS. 12 and 13 show the surgical device 2 moved to a thirdconfiguration from the first configuration of FIG. 10. In the thirdconfiguration, the jaws 12 a, 12 b are in a closed position and havebeen pivoted downward in a downward direction Rd relative to thelongitudinal axis A of the shaft 6. The device 2 is described as movingfrom the first configuration to the third configuration for ease ofdiscussion. The jaws 12 a, 12 b can be articulated downward with thejaws 12 a, 12 b open, closed, or at an intermediate positiontherebetween, and from one downward articulated position to anotherdownward articulated position. The articulation knob 16 can be rotatedin the first direction R1. As the articulation knob 16 rotates in thefirst direction R1 the pin 74 a engaged in sleeve thread 68 can slidetherein so as to drive the articulation sleeve 60 longitudinally in afirst direction D1, e.g., a distal direction. Movement of thearticulation sleeve 60 in the first direction D1 can move thearticulation sleeve 60 from a proximal location to a more distallocation as the articulation sleeve 60 moves distally relative to themain housing 38.

As the articulation sleeve 60 moves longitudinally in the firstdirection D1, the drive bushing 52 also moves longitudinally in thefirst direction D1. The second pin 52 b and the fourth pin 52 c canslide in the second thread 47 of the second helical gear 46, therebydriving the second helical gear 46 and the outer tube 22 in the firstdirection R1. Similar, the first pin 52 a and the third pin can slide inthe first thread 45 of the first helical gear 44, thereby driving thefirst helical gear 44 and the inner tube 20 in the second direction R2opposite to the first direction R1 in which the second helical gear 46is rotating. The rotation of the outer tube 22, and hence the teeth 28at the distal end of the outer tube 22, movably engages the second teeth36 of the second jaw 12 b so as to articulate the second jaw 12 bdownward in the downward direction Rd. Similarly, the rotation of theinner tube 20, and hence the teeth 26 at the distal end of the innertube 20, movably engages the first teeth 34 of the first jaw 12 a so asto articulate the first jaw 12 a downward in the downward direction Rd.Therefore, both of the jaws 12 a, 12 b can be driven in the samedownward direction Rd relative to the shaft 6 in response to rotation ofthe knob 16 in the first direction R1. If the jaws 12 a, 12 b were notclosed prior to the downward pivoting, the jaws 12 a, 12 b can be closedby the actuation of the arms 14 a, 14 b after the downward pivotingactuation.

FIGS. 14 and 15 show the device 2 moved to a fourth configuration fromthe third configuration of FIGS. 12 and 13. In the fourth configuration,the jaws 12 a, 12 b are opened when the jaws 12 a, 12 b are in thearticulated downward position. As mentioned above, the jaws 12 a, 12 bcan alternatively be opened before being pivoted downward. The jaws 12a, 12 b can be opened similar to that discussed with regards to FIG. 11,with the handles 14 a, 14 b being moved apart from one another inopposed upward and downward directions Ru, Rd.

FIGS. 16 and 17 show the surgical device 2 moved to a fifth positionfrom the first configuration of FIG. 10. In the fifth configuration, thejaws 12 a, 12 b are in a closed position and have been pivoted upward inan upward direction Ru relative to the longitudinal axis A of the shaft6. The device 2 is described as moving from the first configuration tothe fifth configuration for ease of discussion. The jaws 12 a, 12 b canbe articulated upward with the jaws 12 a, 12 b open, closed, or at anintermediate position therebetween, and from one upward articulatedposition to another upward articulated position. Articulating the jaws12 a, 12 b upward can be achieved similar to that discussed above withrespect to the jaws 12, 12 b being articulated downward, except that theknob 12 can be rotated in the second direction R2. The rotation of theknob 16 in the second direction R2 can cause the sleeve 60 and thebushing 52 to move in a second direction D2, e.g., a proximal direction,thereby causing the helical gears 44, 46 to rotate in oppositedirections R1, R2. The inner and outer tubes 20, 22 thus rotate inopposite directions, causing the jaws 12 a, 12 b to articulate upward.Actuation of the articulation sleeve 60 in the second direction D2 canmove the articulation sleeve 60 from a distal location to a moreproximal location as the articulation sleeve 60 moves proximallylongitudinally relative to the main housing 38.

FIGS. 18 and 19 show the device 2 moved to a sixth configuration fromthe fifth configuration of FIGS. 16 and 17. In the sixth configuration,the jaws 12 a, 12 b are opened when the jaws 12 a, 12 b are in thearticulated upward position. As mentioned above, the jaws 12 a, 12 b canalternatively be opened before being pivoted upward. The jaws 12 a, 12 bcan be opened similar to that discussed with regards to FIG. 11, withthe handles 14 a, 14 b being moved apart from one another in opposedupward and downward directions Ru, Rd.

The surgical device 2 in the embodiment of FIG. 1 is non-powered suchthat the device's jaw articulation and jaw opening/closing can beachieved mechanically without using any electrical power. In otherembodiments, a surgical device can be powered such that electrical poweris used for at least one of jaw articulation and jaw opening/closing. Inan exemplary embodiment, a surgical device can be powered for jawarticulation and can be non-powered for jaw opening/closing. Jawopening/closing can be more precisely controlled by a user of the devicewhen performed mechanically, since the user can palpably feel theopening and the closing, which can provide an indication as to type,size, etc. of tissue being clamped by the jaws, thereby providingoverall good user experience. Articulation not involving user feel neednot detract from overall good user experience since articulation is moredirected to device positioned than to tissue manipulation.

FIGS. 20-23 illustrate one embodiment of a powered surgical device 102.The surgical device 102 can generally be configured and used similar tothe surgical device 2 of FIG. 1. The device 102 can include a proximalhandle portion 104, an end effector 108 including first and second jaws112 a, 112 b, an elongate shaft 106, a pivot joint 110, a pin 111 vatthe pivot joint 110, a movement assembly, a first actuator 114 a, 114 b,a second actuator 116, first and second drive links 154 a, 154 b, aninner tube bias member 148, and outer tube bias member 150, an anchormember 142, one or more anchor pins 142 a, 142 b, and a main housing 138including housing halves 138 a, 138 b. The elongate shaft 106 caninclude a central shaft 118, an inner tube 120, and an outer tube 120.The movement assembly can include a first helical gear 144, a secondhelical gear 146, a drive bushing 152, and an articulation sleeve 160.

The first actuator 114 a, 114 b can be configured to effect the openingand closing of the opposed jaws 112 a, 112 b, e.g., movement of the jaws112 a, 112 b toward and away from one another, similar to that discussedabove regarding the first actuator 14 a, 14 b of FIG. 1.

The second actuator 116 can be configured to effect the articulation ofthe opposed jaws 112 a, 112 b, e.g., movement of both jaws 112 a, 112 bin a same direction relative to the shaft's longitudinal axis A′,similar to the articulation movement discussed above with respect to thejaws 12 a, 12 b of FIG. 1, but the articulation for the device 102 ofFIG. 20 can be achieved using electrical power. The device 2 can includea power source (not shown), a motor 121, a first transmission gear 124,a second transmission 126, and a drive shaft 128 that can be configuredto assist with powered articulation. The power source, the motor 121,the first transmission gear 124, the second transmission 126, and thedrive shaft 128 can be housed within the main housing 138. In general,actuation of the second actuator 116 can cause the motor 121 to providepower that longitudinally moves the articulation sleeve 160 and thebushing 152, similar to that discussed above for the articulation sleeve60 and the bushing 152 of the device 2 of FIG. 1, so as to articulatethe end effector 108.

The motor 121 can have a variety of configurations e.g., a rotary motor,an electric motor, a pneumatic motor, etc. The motor 121 can beconfigured to be powered by the power source. The power source can havea variety of configurations, e.g., a battery, an electrical power cord,a pneumatic source, etc. The power source can be disposed within thehousing 138, as in this illustrated embodiment, or the power source canbe external, such as if the power source includes an electrical powercord extending from the housing 138 and configured to be plugged into agenerator, a wall outlet, etc. Similarly, the motor 121 is disposedwithin the housing 138 in this illustrated embodiment, but the motor canbe located outside the housing 138. The motor 121 can be configured tobe triggered on via actuation of the second actuator 116. The motor 121can be operatively connected to the first transmission gear 124. Themotor 121 can be coaxially aligned with the first transmission gear 124so that upon power being provided to the motor 121 from the powersource, the first transmission gear 124 can be configured rotate eitherclockwise or counterclockwise, depending on the actuation of the secondactuator 116. The first transmission gear 124 can be operativelyconnected to the second transmission gear 126, as shown in FIGS. 21-23.The second transmission gear 126 can have the drive shaft 128operatively connected thereto such that rotation of the secondtransmission gear 126 can drive rotation of the drive shaft 128. Thedrive shaft 128 can have threads 130 at a distal portion thereof. Thedrive shaft 128 can have the articulation sleeve 160 operativelyattached thereto via the threads 130 such that upon rotation of thedrive shaft 128, the articulation sleeve 160 can be movedlongitudinally, either distally or proximally depending on whether thedrive shaft 128 is rotating clockwise or counterclockwise. Theelectrical power provided by the motor 121 can thus be translated intomechanical movement of the articulation sleeve 160, and hence mechanicalmovement of the bushing 152, the inner and outer tubes 120, 122, and thefirst and second jaws 112 a, 112 b. The articulation sleeve 160 caninclude at least one threaded member 141 a, 141 b configured tothreadably engage the drive shaft threads 130.

The second actuator 116 can have a variety of sizes, shapes, andconfigurations. In an exemplary embodiment, the second actuator 116 caninclude at least one tab 105 configured to be manually actuated by auser, e.g., by being pushed clockwise C1 or counterclockwise C2. Onlyone tab 105 is visible in FIGS. 20 and 23. A second tab is located onthe other housing half 138 but is obscured in FIGS. 20 and 23. Havingtwo tabs 105 on either side of the housing 138 can facilitate actuationof the second actuator 116 regardless of whether a left hand or a righthand of a user is holding the device 2. Actuation of the second actuator116 can cause a switch to be closed, thereby triggering the motor toturn on. For example, movement of the at least one tab 105 clockwise C1can cause a first circuit to close, thereby causing the motor 121 toturn on and rotate the first transmission gear 124 clockwise so as toarticulate the end effector 8, and movement of the at least one tab 105counterclockwise C2 can cause a second circuit to close, thereby causingthe motor 121 to turn on and rotate the first transmission gear 124counterclockwise so as to articulate the end effector 8. When the atleast one tab 105 is released, the closed first or second circuit canopen, thereby causing the motor 121 to turn off and hence causingarticulation of the end effector 8 to stop. The at least one tab 105 canbe in wired communication with the first and second circuits and/or themotor 121, or the at least one tab 105 can be in wireless communicationwith the first and second circuits and/or the motor 121.

A person skilled in the art will appreciate that the present inventionhas application in conventional minimally-invasive and open surgicalinstrumentation as well application in robotic-assisted surgery.

The devices disclosed herein can also be designed to be disposed ofafter a single use, or they can be designed to be used multiple times.In either case, however, the device can be reconditioned for reuse afterat least one use. Reconditioning can include any combination of thesteps of disassembly of the device, followed by cleaning or replacementof particular pieces and subsequent reassembly. In particular, thedevice can be disassembled, and any number of the particular pieces orparts of the device can be selectively replaced or removed in anycombination. Upon cleaning and/or replacement of particular parts, thedevice can be reassembled for subsequent use either at a reconditioningfacility, or by a surgical team immediately prior to a surgicalprocedure. Those skilled in the art will appreciate that reconditioningof a device can utilize a variety of techniques for disassembly,cleaning/replacement, and reassembly. Use of such techniques, and theresulting reconditioned device, are all within the scope of the presentapplication.

One skilled in the art will appreciate further features and advantagesof the invention based on the above-described embodiments. Accordingly,the invention is not to be limited by what has been particularly shownand described, except as indicated by the appended claims. Allpublications and references cited herein are expressly incorporatedherein by reference in their entirety.

What is claimed is: 1-21. (canceled)
 22. A surgical method, comprising:advancing jaws at a distal end of a surgical instrument into a body, thesurgical instrument including a handle, an outer tube extending distallyfrom the handle, and an inner tube disposed within the outer tube andextending distally from the handle; actuating a first actuator coupledto the handle so as to cause the inner and outer tubes to rotate inopposite directions, thereby causing the jaws to articulate in a samedirection as one another; and actuating a second actuator coupled to thehandle so as to cause the inner and outer tubes to rotate in a samedirection, thereby causing the jaws to selectively open and close. 23.The method of claim 22, wherein actuating the first actuator comprisesrotating the first actuator in a first direction or in a seconddirection that is opposite to the first direction, the rotation of thefirst actuator in the first direction causing the outer tube to rotatein the first direction and causing the inner tube to rotate in thesecond direction, and the rotation of the first actuator in the seconddirection causing the outer tube to rotate in the second direction andcausing the inner tube to rotate in the first direction.
 24. The methodof claim 22, wherein actuating the first actuator causes a motor todrive the rotation of the inner and outer tube in the oppositedirections.
 25. The method of claim 22, wherein the second actuatorincludes first and second handles, and actuating the second actuatorcomprises moving the first and second handles toward and away from oneanother.